Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological proc...Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological processes underlying communication between the somatosensory and motor pathways that regulate fine motor skills during spontaneous recovery after spinal cord contusion injury remain unclear.Here, we established a rat model of cervical hemicontusive injury using C5 laminectomy followed by contusional displacement of 1.2 mm(mild injury) or 2.0 mm(severe injury) to the C5 spinal cord.Electrophysiological recordings were performed on the brachial muscles up to 12 weeks after injury to investigate the mechanisms by which spinal cord pathways participate in motor function.After spinal cord contusion injury, the amplitudes of somatosensory and motor-evoked potentials were reduced, and the latencies were increased.The forelimb open field locomotion test, grooming test, rearing test and Montoya staircase test revealed improvement in functions.With increasing time after injury, the amplitudes of somatosensory and motor-evoked potentials in rats with mild spinal cord injury increased gradually, and the latencies gradually shortened.In comparison, the recovery times of somatosensory and motor-evoked potential amplitudes and latencies were longer, and the recovery of motor function was delayed in rats with severe spinal cord injury.Correlation analysis revealed that somatosensoryevoked potential and motor-evoked potential parameters were correlated with gross and fine motor function in rats with mild spinal cord contusion injury.In contrast, only somatosensory-evoked potential amplitude was correlated with fine motor skills in rats with severe spinal cord injury.Our results show that changes in both somatosensory and motor-evoked potentials can reflect the changes in gross and fine motor functions after mild spinal cord contusion injury, and that the change in somatosensory-evoked potential amplitude can also reflect the change in fine motor function after severe spinal cord contusion injury.This study was approved by the Animal Ethics Committee of Nanfang Hospital, Southern Medical University, China(approval No.NFYY-2017-67) on June 11, 2017.展开更多
Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery ...Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and...Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor ...BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.展开更多
Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: ...Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: Fifty elderly women with reduced balance function, admitted to the Qingbar Elderly Care Center of Chongqing Medical University from December 2022 to December 2023, were randomly selected and divided into two groups. The aerobic exercise group (25 patients) received traditional treatment and rehabilitation nursing, while the balance rhythm dance intervention group (25 patients) received the balance rhythm dance intervention in addition to traditional treatment and rehabilitation nursing. The Unified Parkinson’s Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS) were used as evaluation indicators to compare the intervention effects between the two groups. Results: The data revealed that the balance rhythm dance intervention significantly improved the motor ability and balance function of elderly women in the intervention group (P < 0.01), with statistically significant differences observed. Conclusion: The balance rhythm dance program plays a critical role in promoting the rehabilitation of motor function and balance ability in elderly women, effectively enhancing their quality of life.展开更多
Background:Excessive heat exposure can lead to hyperthermia in humans,which impairs physical performance and disrupts cognitive function.While heat is a known physiological stressor,it is unclear how severe heat stres...Background:Excessive heat exposure can lead to hyperthermia in humans,which impairs physical performance and disrupts cognitive function.While heat is a known physiological stressor,it is unclear how severe heat stress affects brain physiology and function.Methods:Eleven healthy participants were subjected to heat stress from prolonged exercise or warm water immersion until their rectal temperatures(T_(re))attained 39.5℃,inducing exertional or passive hyperthermia,respectively.In a separate trial,blended ice was ingested before and during exercise as a cooling strategy.Data were compared to a control condition with seated rest(normothermic).Brain temperature(T_(br)),cerebral perfusion,and task-based brain activity were assessed using magnetic resonance imaging techniques.Results:T_(br)in motor cortex was found to be tightly regulated at rest(37.3℃±0.4℃(mean±SD))despite fluctuations in T_(re).With the development of hyperthermia,T_(br)increases and dovetails with the rising T_(re).Bilateral motor cortical activity was suppressed during high-intensity plantarflexion tasks,implying a reduced central motor drive in hyperthermic participants(T_(re)=38.5℃±0.1℃).Global gray matter perfusion and regional perfusion in sensorimotor cortex were reduced with passive hyperthermia.Executive function was poorer under a passive hyperthermic state,and this could relate to compromised visual processing as indicated by the reduced activation of left lateral-occipital cortex.Conversely,ingestion of blended ice before and during exercise alleviated the rise in both T_(re)and T_(bc)and mitigated heat-related neural perturbations.Conclusion:Severe heat exposure elevates T_(br),disrupts motor cortical activity and executive function,and this can lead to impairment of physical and cognitive performance.展开更多
Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City f...Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.展开更多
Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people...Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people are diagnosed with SCI annually(Singh et al.,2014),and while this number appears quite low,the effect that an SCI has on the patient’s quality of life is drastic,due to the current difficulties to comprehensively treat this illness.The cost of patient care can also be quite costly,amounting to an estimated$1.69 billion in healthcare costs in the USA alone(Mahabaleshwarkar and Khanna,2014).展开更多
To investigate changes of functional activation areas of the cerebral cortex and the connectivity of motor cortex networks （MCNs） in stroke patients during the recovery, five patients with the infarct in their left ...To investigate changes of functional activation areas of the cerebral cortex and the connectivity of motor cortex networks （MCNs） in stroke patients during the recovery, five patients with the infarct in their left hemispheres are recruited. Functional magnetic resonance imaging （fMRI） is performed in the second, fourth, eighth, and sixteenth weeks after the stroke. Images are analyzed using the professional software SPM5 to obtain the bilateral activation of the motor cortex in left and right handgrip tests. MCN data are extracted from the active areas, and the structural and functional characteristic parameters are computed to indicate the connectivity of the network. Results show that the ipsilesional hemisphere recruits more areas with less active extent during the handgrip test, compared with the contralesional hemisphere. MCN shows a higher overall degree of statistical independence and more statistical dependence among motor areas with the gradual recovery. It can help physicians understand the recovery mechanism.展开更多
Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking rec...BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.展开更多
Brain-computer interface(BCI)is an emerging technology with significant potential in clinical neurorestoratology.Over the past two years,various BCI systems,either invasive or non-invasive,have demonstrated promising ...Brain-computer interface(BCI)is an emerging technology with significant potential in clinical neurorestoratology.Over the past two years,various BCI systems,either invasive or non-invasive,have demonstrated promising effectives in clinical neurorestorative applications.These advancements have led to notable progress in areas such as motor function recovery,neurofeedback training,assistive communication,and stroke rehabilitation.展开更多
Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial ...Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the ex...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patien...Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.展开更多
Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we appl...Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we applied EA to the Zusanli(ST36)and Quchi(LI11)acupoints in rats with middle cerebral artery occlusion and reperfusion.We found that EA effectively increased the expression of brain-derived neurotrophic factor and its receptor tyrosine kinase B,synapsin-1,postsynaptic dense protein 95,and microtubule-associated protein 2 in the ischemic penumbra of rats with middle cerebral artery occlusion and reperfusion.Moreover,EA greatly reduced the expression of myelin-related inhibitors Nogo-A and NgR in the ischemic penumbra.Tyrosine kinase B inhibitor ANA-12 weakened the therapeutic effects of EA.These findings suggest that EA can improve neurological function after middle cerebral artery occlusion and reperfusion,possibly through regulating the activity of the brain-derived neurotrophic factor/tyrosine kinase B signal pathway.All procedures and experiments were approved by the Animal Research Committee of Shanghai University of Traditional Chinese Medicine,China(approval No.PZSHUTCM200110002)on January 10,2020.展开更多
Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarctio...Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.展开更多
Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days ...Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days after a rat model of caudate nucleus hemorrhage was established, NSCs and OEC, NSC, OEC （from embryos of Wistar rats） or normal saline were injected into bematomas of rats in combined transplantation group, NSC group, OEC group, and control group, respectively. Damage of neural function was scored before and in 3, 7, 14, 30 days after operation. Tissue after transplantation was observed by immunocytochemistry staining. Results The scores for the NSC, OEC and co-transplantation groups were significantly lower in 14 and 30 days after operation than in 3 days after operation （P〈0.05）. The scores for the NSC and OEC groups were significantly lower than those for the control group only in 30 days after operation （P〈0.05）, while the difference for the NSC-OEC group was significant in 14 days after operation （P〈0.05）. Immunocytochemistry staining revealed that the transplanted OEC and NSC could survive, migrate and differentiate into neurons, astrocytes, and oligodendrocytes. The number of neural precursor cells was greater in the NSC and combined transplantation groups than in the control group. The number of neurons differentiated from NSC was significantly greater in the co-transplantation group than in the NSC group. Conclusion Co-transplantation of NSC and OEC can promote the repair of injured tissue and improve the motor fimction of rats with intracerebral hemorrhage.展开更多
Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect...Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect remain unclear.In the present study, rat models of stroke established by occlusion of the right cerebral middle artery were subjected to tPCS, 20 minutes per day for 7 successive days.tPCS significantly reduced the Bederson score, increased the foot print area of the affected limbs, and reduced the standing time of affected limbs of rats with stroke compared with that before intervention.Immunofluorescence staining and western blot assay revealed that tPCS significantly increased the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.This finding suggests that tPCS can improve the locomotor function of rats with stroke by regulating the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.These findings may provide a new method for the clinical treatment of poststroke motor dysfunction and a theoretical basis for clinical application of tPCS.The study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine of China(approval No.PZSHUTCM190315003) on February 22, 2019.展开更多
基金supported by the National Natural Science Foundation of China, No.81871768(to YH)Chinese Academy of Medical Sciences Initiative for Innovative Medicine of China, No.2016-I2 M-2-006(to HYC)High Level-Hospital Program, Health Commission of Guangdong Province, China, No.HKUSZH201902011(to YH)。
文摘Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological processes underlying communication between the somatosensory and motor pathways that regulate fine motor skills during spontaneous recovery after spinal cord contusion injury remain unclear.Here, we established a rat model of cervical hemicontusive injury using C5 laminectomy followed by contusional displacement of 1.2 mm(mild injury) or 2.0 mm(severe injury) to the C5 spinal cord.Electrophysiological recordings were performed on the brachial muscles up to 12 weeks after injury to investigate the mechanisms by which spinal cord pathways participate in motor function.After spinal cord contusion injury, the amplitudes of somatosensory and motor-evoked potentials were reduced, and the latencies were increased.The forelimb open field locomotion test, grooming test, rearing test and Montoya staircase test revealed improvement in functions.With increasing time after injury, the amplitudes of somatosensory and motor-evoked potentials in rats with mild spinal cord injury increased gradually, and the latencies gradually shortened.In comparison, the recovery times of somatosensory and motor-evoked potential amplitudes and latencies were longer, and the recovery of motor function was delayed in rats with severe spinal cord injury.Correlation analysis revealed that somatosensoryevoked potential and motor-evoked potential parameters were correlated with gross and fine motor function in rats with mild spinal cord contusion injury.In contrast, only somatosensory-evoked potential amplitude was correlated with fine motor skills in rats with severe spinal cord injury.Our results show that changes in both somatosensory and motor-evoked potentials can reflect the changes in gross and fine motor functions after mild spinal cord contusion injury, and that the change in somatosensory-evoked potential amplitude can also reflect the change in fine motor function after severe spinal cord contusion injury.This study was approved by the Animal Ethics Committee of Nanfang Hospital, Southern Medical University, China(approval No.NFYY-2017-67) on June 11, 2017.
基金supported by the NIH (R01NS103481, R01NS111776, and R01NS131489)Indiana Department of Health (ISDH58180)(all to WW)。
文摘Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
文摘Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2023ZL460Zhejiang Province Traditional Chinese Medicine Modernization Special Project,No.2021ZX011。
文摘BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.
基金Chongqing Sports Scientific Research Project“Research and Development of Balance Rhythm Dance and Its Application in Reducing Fall Risk in Older Women”(Project No.D202209)Chongqing Nursing Vocational College College-level Project“Research on the Talent Training Model of Field Engineers in the Intelligent Health Care Sector Based on Rehabilitation Assistive Devices under the‘Integration of Science and Education’Approach”(Project No.Y202307)+1 种基金Chongqing Science and Technology Bureau Research Project“Investigating the Impact of Electro-acupuncture Applied to Antagonist Muscles on Walking Ability in Stroke Patients with Hemiplegia Based on the Principle of Reciprocal Inhibition”(Project No.CSTC2019JXJL130019)Chongqing Traditional Chinese Medicine Hospital Research Project“The Alterations in the Pelvic Floor Muscle Group Following Acupuncture Treatment for Postpartum Stress Urinary Incontinence Were Evaluated Using SWE Technology”(Project No.jxyn2021-2-23)。
文摘Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: Fifty elderly women with reduced balance function, admitted to the Qingbar Elderly Care Center of Chongqing Medical University from December 2022 to December 2023, were randomly selected and divided into two groups. The aerobic exercise group (25 patients) received traditional treatment and rehabilitation nursing, while the balance rhythm dance intervention group (25 patients) received the balance rhythm dance intervention in addition to traditional treatment and rehabilitation nursing. The Unified Parkinson’s Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS) were used as evaluation indicators to compare the intervention effects between the two groups. Results: The data revealed that the balance rhythm dance intervention significantly improved the motor ability and balance function of elderly women in the intervention group (P < 0.01), with statistically significant differences observed. Conclusion: The balance rhythm dance program plays a critical role in promoting the rehabilitation of motor function and balance ability in elderly women, effectively enhancing their quality of life.
基金supported by Defence Innovative Research Program(DIRP)Grant(PA No.9015102335)from Defence Research&Technology Office,Ministry of Defence,Singapore。
文摘Background:Excessive heat exposure can lead to hyperthermia in humans,which impairs physical performance and disrupts cognitive function.While heat is a known physiological stressor,it is unclear how severe heat stress affects brain physiology and function.Methods:Eleven healthy participants were subjected to heat stress from prolonged exercise or warm water immersion until their rectal temperatures(T_(re))attained 39.5℃,inducing exertional or passive hyperthermia,respectively.In a separate trial,blended ice was ingested before and during exercise as a cooling strategy.Data were compared to a control condition with seated rest(normothermic).Brain temperature(T_(br)),cerebral perfusion,and task-based brain activity were assessed using magnetic resonance imaging techniques.Results:T_(br)in motor cortex was found to be tightly regulated at rest(37.3℃±0.4℃(mean±SD))despite fluctuations in T_(re).With the development of hyperthermia,T_(br)increases and dovetails with the rising T_(re).Bilateral motor cortical activity was suppressed during high-intensity plantarflexion tasks,implying a reduced central motor drive in hyperthermic participants(T_(re)=38.5℃±0.1℃).Global gray matter perfusion and regional perfusion in sensorimotor cortex were reduced with passive hyperthermia.Executive function was poorer under a passive hyperthermic state,and this could relate to compromised visual processing as indicated by the reduced activation of left lateral-occipital cortex.Conversely,ingestion of blended ice before and during exercise alleviated the rise in both T_(re)and T_(bc)and mitigated heat-related neural perturbations.Conclusion:Severe heat exposure elevates T_(br),disrupts motor cortical activity and executive function,and this can lead to impairment of physical and cognitive performance.
文摘Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.
基金supported by the Irish Research Council under the Government of Ireland Postdoctoral Fellowship Project ID-GOIPD/2023/1431(to AS).
文摘Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people are diagnosed with SCI annually(Singh et al.,2014),and while this number appears quite low,the effect that an SCI has on the patient’s quality of life is drastic,due to the current difficulties to comprehensively treat this illness.The cost of patient care can also be quite costly,amounting to an estimated$1.69 billion in healthcare costs in the USA alone(Mahabaleshwarkar and Khanna,2014).
基金Supported by the National Natural Science Foundation of China (30670543)~~
文摘To investigate changes of functional activation areas of the cerebral cortex and the connectivity of motor cortex networks （MCNs） in stroke patients during the recovery, five patients with the infarct in their left hemispheres are recruited. Functional magnetic resonance imaging （fMRI） is performed in the second, fourth, eighth, and sixteenth weeks after the stroke. Images are analyzed using the professional software SPM5 to obtain the bilateral activation of the motor cortex in left and right handgrip tests. MCN data are extracted from the active areas, and the structural and functional characteristic parameters are computed to indicate the connectivity of the network. Results show that the ipsilesional hemisphere recruits more areas with less active extent during the handgrip test, compared with the contralesional hemisphere. MCN shows a higher overall degree of statistical independence and more statistical dependence among motor areas with the gradual recovery. It can help physicians understand the recovery mechanism.
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
文摘BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.
文摘Brain-computer interface(BCI)is an emerging technology with significant potential in clinical neurorestoratology.Over the past two years,various BCI systems,either invasive or non-invasive,have demonstrated promising effectives in clinical neurorestorative applications.These advancements have led to notable progress in areas such as motor function recovery,neurofeedback training,assistive communication,and stroke rehabilitation.
基金supported by the 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University,China,No.2020HXFH051(to QG).
文摘Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
基金supported by the Sub-Project under National "Twelfth Five-Year" Plan for Science&Technology Support Project in China,No.2011BAI08B11the Research Project of China Rehabilitation Research Center,No.2014-3
文摘Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.
基金supported by the National Key R&D Program of China,No.2018YFC2001600(to JGX)the National Natural Science Foundation of China,No.81902301(to JJW)+3 种基金Budgetary Project of Shanghai University of Traditional Chinese Medicine of China,No.2019LK024(to JJW)Intelligent Medical Program of Shanghai(Municipal)Health Commission of China,No.2018ZHYL0216(to CLS)Clinical Science and Technology Innovation Project of Shanghai Shen Kang Hospital Development Center of China,No.SHDC12018126(to CLS)Accelerated the Development of Traditional Chinese Medicine Three-Year Action Plan Project(of Shanghai Health Commission)of China,Nos.ZY(2018-2020)-CCCX-2001-06(to JGX and CLS)and ZY(2018-2020)-CCCX-2004-05(to JGX and CLS)。
文摘Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we applied EA to the Zusanli(ST36)and Quchi(LI11)acupoints in rats with middle cerebral artery occlusion and reperfusion.We found that EA effectively increased the expression of brain-derived neurotrophic factor and its receptor tyrosine kinase B,synapsin-1,postsynaptic dense protein 95,and microtubule-associated protein 2 in the ischemic penumbra of rats with middle cerebral artery occlusion and reperfusion.Moreover,EA greatly reduced the expression of myelin-related inhibitors Nogo-A and NgR in the ischemic penumbra.Tyrosine kinase B inhibitor ANA-12 weakened the therapeutic effects of EA.These findings suggest that EA can improve neurological function after middle cerebral artery occlusion and reperfusion,possibly through regulating the activity of the brain-derived neurotrophic factor/tyrosine kinase B signal pathway.All procedures and experiments were approved by the Animal Research Committee of Shanghai University of Traditional Chinese Medicine,China(approval No.PZSHUTCM200110002)on January 10,2020.
基金supported by the Guangdong Province Medical Science Research Fund, No. B200258
文摘Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.
基金supported by the National Natural Science Foundation of China (30570628 & 30770751)
文摘Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days after a rat model of caudate nucleus hemorrhage was established, NSCs and OEC, NSC, OEC （from embryos of Wistar rats） or normal saline were injected into bematomas of rats in combined transplantation group, NSC group, OEC group, and control group, respectively. Damage of neural function was scored before and in 3, 7, 14, 30 days after operation. Tissue after transplantation was observed by immunocytochemistry staining. Results The scores for the NSC, OEC and co-transplantation groups were significantly lower in 14 and 30 days after operation than in 3 days after operation （P〈0.05）. The scores for the NSC and OEC groups were significantly lower than those for the control group only in 30 days after operation （P〈0.05）, while the difference for the NSC-OEC group was significant in 14 days after operation （P〈0.05）. Immunocytochemistry staining revealed that the transplanted OEC and NSC could survive, migrate and differentiate into neurons, astrocytes, and oligodendrocytes. The number of neural precursor cells was greater in the NSC and combined transplantation groups than in the control group. The number of neurons differentiated from NSC was significantly greater in the co-transplantation group than in the NSC group. Conclusion Co-transplantation of NSC and OEC can promote the repair of injured tissue and improve the motor fimction of rats with intracerebral hemorrhage.
基金supported by the National Key R&D Program of China, No.2018 YFC2001600(to CLS)the Shanghai Health Commission Accelerated the Development of Traditional Chinese Medicine Three-Year Action Plan Project, No.ZY(2018-2020)-CCCX-2001-06/2004-05(to CLS)+1 种基金the Program of Shanghai Academic Research Leader, No.19 XD1403600(to CLS)the National Natural Science Foundation of China for the Youth Project, No.81704163(to JJZ)。
文摘Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect remain unclear.In the present study, rat models of stroke established by occlusion of the right cerebral middle artery were subjected to tPCS, 20 minutes per day for 7 successive days.tPCS significantly reduced the Bederson score, increased the foot print area of the affected limbs, and reduced the standing time of affected limbs of rats with stroke compared with that before intervention.Immunofluorescence staining and western blot assay revealed that tPCS significantly increased the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.This finding suggests that tPCS can improve the locomotor function of rats with stroke by regulating the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.These findings may provide a new method for the clinical treatment of poststroke motor dysfunction and a theoretical basis for clinical application of tPCS.The study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine of China(approval No.PZSHUTCM190315003) on February 22, 2019.
